1. Field of the Invention
The present invention relates to an improved method for managing the delivery of information within an enterprise and, more specifically, it relates to a method for notifying users about information or events of the enterprise, and, most specifically, it is particularly advantageous in selecting one or more communication channels to communicate messages from an event monitor. The invention also relates to an improved system for notifying users about information or events of the enterprise.
2. Description of the Prior Art
An event monitor looks for specific patterns in data, which define types of events, being passed to it from a data store, such as a data warehouse or database. Typically, if the event monitor finds a pattern in the data (i.e., an "event"), the event monitor evokes an inference engine, such as a rule-based expert system.
A clinical event monitor refers to an embedded expert system in the domain of clinical medicine. Clinical event monitoring may be classified as synchronous (e.g., the expert system runs in response to data entered by a clinician in real time, as in order entry) or asynchronous (e.g., all other circumstances, for example, when it is triggered by the arrival of laboratory results).
A clinical event monitor evaluates events, in the context of information that may be known about a patient, and communicates conclusions via a communication channel to a user. The basic infrastructure needed to support event monitoring is a source of events, a source of patient data and a notification service. The event monitor itself is an algorithm that takes as input events, patient data and a representation of medical knowledge in various formats (e.g., rules), and outputs messages.
An event is data that triggers the execution of an event monitor. Events may be classified into four types: atomic, compound, atomic temporal and compound temporal. An atomic event is an event for which there is a 1-to-1 correspondence with external data. For example, in many systems the storage of a new laboratory result is an identifiable data event that corresponds to an event of interest to domain experts.
A compound event is defined by a static pattern in data. For example, the event that an elderly patient is admitted to the hospital may be of interest to a domain expert, but it does not correspond to a single data event. The detection of compound events does not require that the event detector maintain a persistent store of its own.
An atomic future event is an atomic event, usually created by the event monitor itself, that causes an inference algorithm to run at some time in the future (e.g., an event monitor schedules a check for the existence of a gentamicin level 48 hours after the start of gentamicin). To implement atomic future events, an event monitor has access to a persistent data store.
A compound temporal event is a sequence of data that, when recognized, causes the inference engine to run. Compound temporal events employ both persistent storage and algorithms that recognize temporal patterns. The typical locus for most temporal inference is within the expert system, not at the level of event, although there is a need to map from temporal patterns in the data to events of interest for knowledge users.
Typically, legacy systems rarely produce data that support 1-to-1 mappings to events; hence, many events are compound temporal events. For example, the storage of an HL-7 transaction of a potassium result from a laboratory into a database is not considered to be an atomic event because it could be a duplicate. Only after an algorithm checks this datum against a persistent store of transactions to ensure that it has not been processed earlier, is it considered an event. Another example of a compound temporal event is in the area of drug monitoring where an event of interest to a domain expert is whether the dose of a medication has changed. This event cannot be seen directly in the data. Instead, it must be deduced from a sequence of records in which the meditation is discontinued then restarted at a different dose.
Clinical event monitors are employed to improve the quality and lower the cost of health care by providing information to health care providers as they need it. The clinical event monitor may warn a provider about a medication because of an allergy, drug interaction or side effect. It may also interpret a laboratory test, remind a provider about following up on a screening test, or suggest a diagnosis or new treatment option. The clinical event monitor may coordinate a complex clinical protocol, making sure that each provider is aware of his or her part in that protocol. The goal of a clinical event monitor is not to replace the health care provider, but to make his or her job easier.
An example of a clinical event monitor is discussed in Hripcsak, G., et al., "Design of a Clinical Event Monitor," Computers and Biomedical Research, Vol. 29, pp. 194-221 (1996). As stated in the Hripcsak et al. article, a message from a clinical event monitor may be sent to a provider, depending on the urgency of the message, the availability of the provider and knowledge of who to send the message to, by electronic mail, through an alpha-numeric paging system, through an electronic patient record, via a facsimile machine, over surface mail or through a human intermediary. If the provider does not acknowledge that a message was received, then an alternate route may be chosen. A message may instead go to a patient or the patient's family. Messages may be stored in the patient record or routed to a particular individual. In most systems, messages that are routed to an individual are also stored in a patient database as a legal record. Computer-generated voice messages can be sent automatically by the event monitor. A printed report may be mailed or inserted into the paper chart for a patient. A message may be integrated into the clinical information system, appear on a terminal at the patient's location (e.g., an intensive care unit (ICU) terminal), appear to a user when he or she logs on to the system, or be attached to relevant patient data (e.g., the event data that caused a rule to be triggered). An urgent message might be sent by pager, whereas a passive informational message may simply be attached to the chart.
As shown in FIG. 2 of the Hripcsak et al. article, Medical Logic Module (MLM) rules in the clinical event monitor are written in an Arden Syntax and employ Arden write statements to send messages.
Hripcsak U.S. Pat. No. 5,555,191 discusses various prior art references regarding clinical event monitors, one of which employs the Arden Syntax MLMs. Whenever a medical event occurs, the MLMs that are pertinent to that event are triggered. The MLMs read data from the hospital database, test a set of criteria and, if those criteria are satisfied, perform some action such as sending a message via electronic-mail, storing a message in the patient database or triggering other MLMs.
U.S. Pat. No. 5,555,191 also discloses an automated statistical tracking device designed to detect malfunctions in three separate systems including a clinical event monitor, a patient registration system and a laboratory system, each of which generates messages. These systems also store their respective messages in three log files for the statistical tracking device.
It is known to employ the selective dissemination of information in which computer systems filter new information (e.g., by employing the Boolean combination of keywords, such as, "word1" AND "word2") on behalf of users, and collect user relevance feedback to refine the filters.
It is also known to employ intelligent agents, such as computer programs called agents, to filter information on behalf of users. For example, a user of the Internet may specify to such an agent the user's interest in new web pages concerning a specified topic. As new web pages concerning that topic become available on the Internet, the agent sends an e-mail message to the user to provide notification of the availability of the new web page.
Although various types of actions and communication channels are available to the rules of the clinical event monitor, there is room for improvement.